Provider Demographics
NPI:1336304401
Name:GAZZOLA, JESSICA Z (AP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:Z
Last Name:GAZZOLA
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 SUMMER LAKES CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5137
Mailing Address - Country:US
Mailing Address - Phone:407-883-8873
Mailing Address - Fax:407-523-6103
Practice Address - Street 1:200 N DENNING DR
Practice Address - Street 2:SUITE 7
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3736
Practice Address - Country:US
Practice Address - Phone:407-883-8873
Practice Address - Fax:407-523-6103
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2337171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist